scholarly journals Patients’ demographic and clinical characteristics and level of care associated with lost to follow-up and mortality in adult patients on first-line ART in Nigerian hospitals

2012 ◽  
Vol 15 (2) ◽  
Author(s):  
Solomon Odafe ◽  
Ochanya Idoko ◽  
Titilope Badru ◽  
Bolatito Aiyenigba ◽  
Chiho Suzuki ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Adult Patients ◽  
Level Of Care ◽  
First Line ◽  
Lost To Follow Up

scholarly journals 204 A lost-to-follow-up autoantibody for the diagnosis of autoimmune disease: prevalence and clinical characteristics of anti-NOR90/hUBF positive patients

Rheumatology ◽  
2018 ◽  
Vol 57 (suppl_3) ◽  
Author(s):  
Christos Koutsianas ◽  
Kirsty Levasseur ◽  
Megan Rutter ◽  
Caroline Webber ◽  
Malini V Bhole ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Clinical Characteristics ◽  
Disease Prevalence ◽  
Lost To Follow Up

scholarly journals Real World Outcomes of Adult Patients with Diffuse Large B-Cell Lymphoma Receiving Fixed Dose Intravenous Rituximab in the Philippine General Hospital

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 5029-5029
Author(s):  
Josephine Anne Lucero ◽  
Danielle Benedict Sacdalan ◽  
Cecilia Jimeno ◽  
Ivy Mae S. Escasa
Keyword(s):  
B Cell ◽  
Board Of Directors ◽  
B Cell Lymphoma ◽  
Response Rates ◽  
Adult Patients ◽  
Fixed Dose ◽  
Average Dose ◽  
Advisory Committees ◽  
Lost To Follow Up

Abstract Introduction. Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of aggressive non-Hodgkin lymphoma (NHL). The backbone of therapy includes rituximab at a dose of 375 mg/m 2 however, the rationale for which is not explained in pharmacokinetic studies but has been the set dose for succeeding clinical trials. In limited-resource settings, standard regimen or fixed dose adaptations of certain cancer medicines are common. This study investigated the clinical profile and treatment outcomes of patients who received fixed dose intravenous (IV) rituximab of 500 mg per cycle for DLBCL. Methods. This study was a retrospective cohort conducted through review of records of adults diagnosed with DLBCL given fixed dose IV rituximab of 500mg at the University of the Philippines - Philippine General Hospital from January 1, 2015 to December 31, 2019. Clinical characteristics, stage, international prognostication index (IPI), body surface area dosing, response assessment, and overall survival (OS) and progression-free survival (PFS) were recorded. The computed sample size was 110 patients however, all patients within the period of observation were included. Results. One hundred thirty-two adult patients with DLBCL were identified of which, 77 received a rituximab-based regimen, and 71 received fixed dose IV rituximab of 500mg and were included in the study. Table 1 summarizes the baseline demographic and clinical characteristics of the participants. The mean age was 46 years old with a slight male predominance. Eighty percent of patients received a dose below 350 mg/m 2. Fifty-one percent of patients had bulky and advanced stage of disease. Thirty-nine percent of patients presented with B symptoms. Eighty-two percent had one or no comorbidities on consult. Sixty-six percent had a low-risk IPI of 0 or 1, 30% with a low-intermediate risk IPI of 2, and 4% with a high-intermediate risk IPI of 3. Ninety percent of patients received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). The mean number of doses of rituximab received was 6 and patients received treatment at a mean interval of 1 month from diagnosis. Notably, only three patients underwent immunohistochemistry studies to determine the subtype of DLBCL. All three were found to have activated B cell as the cell of origin. Table 2 summarizes the distribution of outcomes in relation to average dose received. Of the original 71 who received fixed-dose Rituximab, 25 patients had no documentation of objective response assessment. Thirty or 43% showed complete response and 20% showed progressive disease. Complete response was documented across dose ranges from 250 to 400 mg/m 2 however, 77% of complete responders received a dose lower than 350 mg/m 2. Conversely, 79% of patients with progressive disease received a dose lower than 350 mg/m 2. There were no noted significant associations between these outcomes and the average dose range of rituximab received based on Fisher's exact test. This finding is also illustrated in Figure 1, which is a boxed plot diagram of the range of dose received across clinical outcomes. Because of the limited number of patients and sparse distribution of outcomes, a Cox proportional hazard model could not be made. Table 3 shows the distribution of characteristics across clinical outcomes. Age and follow-up time were significantly different across the three groups. No difference was found for the other clinical variables. A Kaplan-Meier survival plot could not be constructed due to the high lost to follow-up rate, with 66% of patients being lost to follow-up at time of analysis. Discussion and Conclusions. The study identified the high use of fixed dose IV rituximab in our hospital rather than the recommended dosing of 375 mg/m 2. These patients showed comparable initial response rates of fixed dose rituximab in adult patients with DLBCL compared to response rates from previous RCTs, however long-term response rates were not evaluable. The study was not able to demonstrate the durability of response, given the lack of data and high lost to follow-up rate. At the time of analysis, the use of subcutaneous (SC) rituximab has not progressed in the treatment center, and the prohibitive cost of both IV and SC rituximab has affected its optimal use. Pharmacokinetic modeling and longer-term cohorts of fixed-dose studies may provide more robust data to support the use of fixed-dose treatment strategies. Figure 1 Figure 1. Disclosures Jimeno: Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Merck Sharp & Dohme: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Johnson and Johnson: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Astrazeneca: Speakers Bureau; Sanofi: Speakers Bureau; Servier: Speakers Bureau; Pfizer: Speakers Bureau. Escasa: Janssen: Membership on an entity's Board of Directors or advisory committees, Other: lecturer, registration and travel grants; Novartis: Other: lecturer, registration and travel grants; Roche: Other: lecturer; Sun Pharma: Other: lecturer, registration and travel grants.

scholarly journals Paediatric Tuberculosis at the Directly Observed Treatment Short-Course Clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

2020 ◽  
pp. 32-38
Author(s):  
B. I. Garba ◽  
T. Yusuf ◽  
L. K. Coker ◽  
K. O. Isezuo ◽  
M. O. Ugege ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Relevant Information ◽  
University Teaching ◽  
First Line ◽  
Successful Treatment Outcome ◽  
Short Course ◽  
Directly Observed Treatment ◽  
Lost To Follow Up ◽  
Paediatric Tuberculosis

Introduction: Tuberculosis (TB) is the leading infectious disease killer worldwide, despite significant progress against the disease in recent years. Most cases of TB in children occur in the TB endemic countries but the actual burden of paediatric TB is unknown. With early diagnosis and treatment using the first-line anti-tuberculous drugs, most people who develop the disease can be cured and onward transmission of infection curtailed. Objective: To determine the pattern and outcome of paediatric tuberculosis managed at a tertiary facility in Sokoto, Nigeria. Materials and Methods: Records of children managed for TB at the Directly observed treatment short-course (DOTS) clinic over a three-and-a-half-year period were reviewed retrospectively. All children (≤ 15 years) treated for TB over the study period was included. Relevant information was retrieved from the register and analysed accordingly. Results: 74 children were treated with 33(44.6%) being males, giving a M: F ratio of 1:1.2. Mean (±SD) age was 85.78 (±55.40) months and 34 (45.9%) belonged to the 0.0-5.0-year age group. Seventy-one (95.9%) were new cases and three (4.1%) were relapse. Pulmonary TB (PTB) was seen in 50 (67.6%), more females had PTB than males, which was not significant (χ2=0.4, p=0.52). Acid fast bacilli (AFB) were positive in only 8 (10.8%) while GeneXpert MTB/RIF sensitivity was detected in 7 (9.2%). Majority 36 (48.6%) were lost to follow up, 30 (40.5%) completed treatment, only 4(5.4%) were cured with no recorded mortality. Successful treatment outcome was low (45.9%). Conclusion: Treatment outcome using DOTS strategy was poor, far below the WHO benchmark. There is need to improve adherence to DOTs therapy to prevent development of multi drug resistant TB. 

scholarly journals Profiles of HIV Care Disruptions Among Adult Patients Lost to Follow-up in Zambia

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Aaloke Mody ◽  
Kombatende Sikombe ◽  
Laura K. Beres ◽  
Sandra Simbeza ◽  
Njekwa Mukamba ◽  
...  
Keyword(s):  
Adult Patients ◽  
Hiv Care ◽  
Lost To Follow Up

Characteristics of elderly metastatic prostate cancer (M1 PC) long-term survivors in the SEER Medicare database receiving androgen-deprivation therapy (ADT)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17513-e17513
Author(s):  
N. A. Obeidat ◽  
C. D. Mullins ◽  
E. Onukwugha ◽  
B. Seal ◽  
A. Hussain
Keyword(s):  
Clinical Characteristics ◽  
Population Based ◽  
Short Term ◽  
Time To First Treatment ◽  
Medicare Database ◽  
Different Characteristics ◽  
Lost To Follow Up ◽  
Long Term Survivors

e17513 Background: ADT remains standard treatment for pts with M1 PC, with radiation (RT) and chemotherapy (CT) providing additional palliation. This population-based analysis evaluated if long-term survivors (LT) receiving ADT possessed different characteristics relative to short-term survivors (ST). Methods: Pts age >/= 66y in SEER Medicare diagnosed with M1 PC between 1998 and 2002 and receiving ADT with or without subsequent CT were identified. Median overall survival (OS) for the sample was used as a cut-off to categorize ST and LT pts. Within these categories, demographic, and clinical characteristics were evaluated. Results: 2,665 ADT pts were first identified who had median OS of 26 months (95% CI 24.0 - 27.0). 1,349 pts died at </= 26 months (ST pts), while 1,245 pts survived or were lost to follow-up beyond 26 months (LT pts). Median time to first treatment with ADT was 1 mo in both ST and LT groups. Within this 66y+ population, LT pts were younger (p < 0.0001), more likely to be married (p = 0.0277), and were comprised of lower % of non-Hispanic white pts and higher % of ‘other’ races, but comparable % of African American and White-Hispanics (p = 0.0005). Distributional differences in PSA were detected, but interpreting the results was difficult due to missing or unknown information. Both ST and LT pts received RT and prostatectomy at similar rates, but LT pts had less comorbidities (p = 0.0008), and were more likely to receive CT (p = 0.0026). Conclusions: Long-term survivors were found to have demographic and clinical characteristics that differed from short-term survivors. Evidence regarding how these characteristics simultaneously impact the type and timing of treatment as well as survival deserve more exploration. [Table: see text]

scholarly journals Comparison of first-line tuberculosis treatment outcomes between previously treated and new patients: a retrospective study in Machakos subcounty, Kenya

2020 ◽  
Author(s):  
Johannes Ndambuki ◽  
Joseph Nzomo ◽  
Lucy Muregi ◽  
Chris Mutuku ◽  
Francis Makokha ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Adverse Outcome ◽  
Previous Treatment ◽  
First Line ◽  
Adherence Support ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Lost To Follow Up

Abstract Background Since 2016, patients with rifampicin-susceptible tuberculosis (TB) have been treated with the 6-month first-line regimen, regardless of treatment history. We assessed treatment outcomes of previously treated and new patients in Machakos subcounty, Kenya. Methods We performed a retrospective cohort study in patients started on first-line treatment between 2016 and 2017. Firth's logistic regression was used to estimate the effect of previous treatment on having a programmatic adverse outcome (either lost to follow-up, death, failure) and treatment failure vs treatment success (either cure or completion). Results Of 1024 new and 79 previously treated patients, 88.1% and 74.7% were treated successfully, 6.5% and 7.6% died, 4.2% and 10.1% were lost to follow-up and 1.2% and 7.6% had treatment failure, respectively. Previous treatment predicted having a programmatic adverse outcome (adjusted odds ratio [aOR] 2.4 [95% confidence interval {CI} 1.4 to 4.2]) and treatment failure (aOR 7.3 [95% CI 2.6 to 20.4]) but not mortality. Similar correlations were found in 334 new and previously treated patients with confirmed baseline rifampicin susceptibility. Conclusion Previously treated patients were more at risk of experiencing a poor treatment outcome, mainly lost to follow-up and treatment failure. Adherence support may reduce lost to follow-up. Rifampicin drug susceptibility testing coverage should increase. More robust retreatment regimens may reduce treatment failure.

scholarly journals Multidisciplinary Management of Pediatric Sports-Related Concussion

2016 ◽  
Vol 44 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Michael J. Ellis ◽  
Lesley J. Ritchie ◽  
Patrick J. McDonald ◽  
Dean Cordingley ◽  
Karen Reimer ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Return To Play ◽  
Multidisciplinary Management ◽  
Duration Of Symptoms ◽  
Clinical Criteria ◽  
Pediatric Concussion ◽  
The Mean ◽  
Concussion Recovery ◽  
Lost To Follow Up

AbstractObjectives: To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. Methods: We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. Results: 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Conclusion: Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.

scholarly journals Clinical Characteristics and Treatment Outcome of Pediatric Rhabdomyosarcoma; Retrospective Review

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Zunaira Shaukat ◽  
Raheela Mansoor ◽  
Najma Shaheen ◽  
Saliha Sarfraz ◽  
Komal Seher
Keyword(s):  
Treatment Outcome ◽  
Clinical Characteristics ◽  
Chart Review ◽  
Treatment Plan ◽  
Retrospective Chart Review ◽  
Group Classification ◽  
Primary Tumor Site ◽  
Lost To Follow Up ◽  
Late Stages

Introduction: Rhabdomyosarcoma is the most common soft tissue sarcoma in children. This paper aimed to assess the stage, site, and treatment outcome among rhabdomyosarcoma (RMS) patients. Materials and Methods: A retrospective chart review was completed from January 2011 to December 2017 of patients that presented to the Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, for the management of RMS. Data collection included clinical characteristics, staging, grouping, risk stratification, treatment plan, radiotherapy doses, and treatment outcome. Results: Among 24 subjects, there were a total of 13 (54.2%) males and 11 (45.8%) females. The median age at the time of diagnosis was 2.5 years (range: 0.75 - 17 years). The majority of the subjects (91.7%) were less than 10 years of age. The median follow-up time was 0.6 years. According to the Children's Oncology Group Classification, 4 (16.7%) subjects were classified as low risk, 14 (58.3%) subjects were rated as intermediate risk, and 6 (0.25%) subjects were stratified as high risk. The most common primary tumor site were genitourinary (62.5%) and abdomen/retroperitoneal (20.8%) regions. At the time of analysis, nine (37.5%) subjects had died because of the disease, twelve (50%) were alive with no evidence of disease, and one subject had a recurrence of disease and was alive. One subject had abandoned the therapy, and another was lost to follow-up. Conclusion: Patients with Rhabdomyosarcoma presented at the late stages of the disease, and it most frequently affected genitourinary and abdomen or retroperitoneal areas. Overall, Rhabdomyosarcoma was found to have a poor outcome to therapy.

scholarly journals Efficacy of Artemisinin-lumefantrine for the treatment of uncomplicated malaria after more than a decade of its use in Kenya

2020 ◽  
Author(s):  
Gabriel M. Kishoyian ◽  
Eliud N. M. Njagi ◽  
George O. Orinda ◽  
Francis T. Kimani ◽  
Kevin Thiongo ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Uncomplicated Malaria ◽  
Standard Dose ◽  
Parasite Clearance ◽  
First Line ◽  
Study Population ◽  
Treatment Responses ◽  
Lost To Follow Up ◽  
Line Drug

Abstract Background: Plasmodium falciparum resistance to antimalarial drugs remains to be a major threat to the control of malaria globally. After the deployment of artemisinin-based combination therapy (ACT), there have been reports of reduced sensitivity of the drug to parasite clearance. In Kenya, artemisinin-lumefantrine (AL) is the recommended first-line drug in the treatment of uncomplicated malaria. This study sought to assess the efficacy of AL after its reintroduction in Kenya, a decade later. In this study, we assessed clinical and parasitological responses of children under five years in May and November 2015 in Chulaimbo sub-County, Kisumu, Kenya.Method: Patients of ≥6 and ≤60 months of age with confirmed Plasmodium falciparum mono-infection were enrolled in the study. The patients were treated with a standard dose of AL and followed up for 28 days. During which period we monitored treatment responses and follow-up adherence.Results: Of the 90 patients enrolled, fourteen (14) were lost to follow-up, with 76 completing the study period. Seventy-five patients 75 (98.7%) cleared, parasitemia within 48 hours while one (1.3%) cleared on day 3. There was 100% clinical and parasitological parasite clearance. Conclusion: Artemisinin lumefantrine was found to be highly efficacious to plasmodium falciparum parasites in children aged ≥6 and ≤60 months. Based on this, the drug can be used to treat uncomplicated malaria in the study population. However, there is need for continued monitoring of its effectiveness in children and adults to counter the threat of resistance.

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